Abstract
Background:Immunogenicity against adalimumab leads to loss of response and secondary failure to biologic therapy; however, concomitant use of methotrexate (MTX) seems to reduce the development of anti-drug antibodies (ADAbs) in a dose-dependent manner. Suboptimal adherence to MTX may favour ADAbs appearance.Objectives:To evaluate the relationship between MTX adherence and ADAbs development.Methods:Observational study among adult patients with chronic inflammatory arthropathy, followed in a tertiary care centre, who were in treatment with MTX and adalimumab. ADAbs formation in relation to MTX adherence was assessed.Results:33 patients were included, with a MTX adherence overall mean of 82.13 (12.45%-100%, median adherence 92.19%). Only 9.09% (n=3) of the patients developed ADAbs, being its MTX adherence mean of 60.95% (46.47%-70%, median adherence 66.39%); ADAbs negative group showed an average MTX adherence of 84.23% (12.45%-100%, median adherence 94.29%). A statistically significant result (p<0.05) between groups was found.Table 1.Baseline characteristics of the patients with RA (n=450), mean±SD/n(%)nAdherence meanADAbs (+)3 (9.09%)60.95%p<0.05ADAbs (-)30 (90.91%)84.23%Total33 (100%)82.13%No statistically significant differences (p>0.05) involving MTX adherence and its dose were found.Conclusion:While the sample is small, this study suggests that ADAbs development may be influenced by MTX adherence, thereby promoting adequate MTX adherence should be a priority in the daily practice of every rheumatologist.
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